U.S. Department of Health & Human Services Divider Arrow National Institutes of Health Divider Arrow NCATS

Details

Stereochemistry ABSOLUTE
Molecular Formula C16H16ClN3O4
Molecular Weight 349.769
Optical Activity UNSPECIFIED
Defined Stereocenters 3 / 3
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of LORACARBEF ANHYDROUS

SMILES

[H][C@]12CCC(Cl)=C(N1C(=O)[C@H]2NC(=O)[C@H](N)C3=CC=CC=C3)C(O)=O

InChI

InChIKey=JAPHQRWPEGVNBT-UTUOFQBUSA-N
InChI=1S/C16H16ClN3O4/c17-9-6-7-10-12(15(22)20(10)13(9)16(23)24)19-14(21)11(18)8-4-2-1-3-5-8/h1-5,10-12H,6-7,18H2,(H,19,21)(H,23,24)/t10-,11-,12+/m1/s1

HIDE SMILES / InChI

Description
Curator's Comment: Description was created based on several sources, including https://www.ncbi.nlm.nih.gov/pubmed/7686466 | http://www.rxlist.com/lorabid-drug.htm

Loracarbef (KT3777) is carbacephem antibiotic structurally identical to cefaclor, except that the sulfur atom of position 1 of the cephem nucleus has been replaced by carbon. It showed good affinity for penicillin-binding proteins. At low concentrations (< 2 mg/L) in vitro, it inhibits Streptococcus pneumoniae, S. pyogenes, beta-haemolytic streptococci groups B, C and G. Proteus mirabilis and Moraxella catarrhalis, including beta-lactamase-producing strains. At therapeutic plasma concentrations it is also active in vitro against most strains of Staphylococcus aureus, S. saprophyticus, Escherichia coli and beta-lactamase-positive and -negative strains of Haemophilus influenzae. Loracarbef has been indicated in the treatment of patients with mild to moderate infections caused by susceptible strains of the designated microorganisms.

Approval Year

Targets

Targets

Primary TargetPharmacologyConditionPotency
Conditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Curative
LORABID

Approved Use

Loracarbef is indicated in the treatment of patients with mild to moderate infections caused by susceptible strains of the designated microorganisms in the conditions listed below. (As recommended dosages, durations of therapy, and applicable patient populations vary among these infections, please see DOSAGE AND ADMINISTRATION for specific recommendations.) Lower Respiratory Tract: Secondary Bacterial Infection of Acute Bronchitis caused by S. pneumoniae, H. influenzae(including b-lactamase-producing strains), or M. catarrhalis (including b-lactamase-producing strains). Acute Bacterial Exacerbations of Chronic Bronchitis: caused by S. pneumoniae, H. influenzae (including b-lactamase-producing strains), or M. catarrhalis (including b-lactamase-producing strains). Pneumonia: caused by S. pneumoniae or H. influenzae (non-b-lactamase-producing strains only). Data are insufficient at this time to establish efficacy in patients with pneumonia caused by b-lactamase-producing strains of H. influenzae. Upper Respiratory Tract: Otitis Media† caused by S. pneumoniae, H. influenzae (including b-lactamase-producing strains), M. catarrhalis (including b-lactamase-producing strains), or S. pyogenes. Acute Maxillary Sinusitis:† caused by S. pneumoniae, H. influenzae (non-b-lactamase-producing strains only), or M. catarrhalis (including b-lactamase-producing strains). Data are insufficient at this time to establish efficacy in patients with acute maxillary sinusitis caused by b-lactamase-producing strains of H. influenzae. † NOTE: In a patient population with significant numbers of b-lactamase-producing organisms, loracarbef's clinical cure and bacteriological eradication rates were somewhat less than those observed with a product containing a b-lactamase inhibitor. Loracarbef's decreased potential for toxicity compared to products containing b-lactamase inhibitors along with the susceptibility patterns of the common microbes in a given geographic area should be taken into account when considering the use of an antimicrobial (see CLINICAL STUDIES.) Pharyngitis and Tonsillitis: caused by S. pyogenes. (The usual drug of choice in the treatment and prevention of streptococcal infections, including the prophylaxis of rheumatic fever, is penicillin administered by the intramuscular route. Loracarbef is generally effective in the eradication of S. pyogenes from the nasopharynx; however, data establishing the efficacy of loracarbef in the subsequent prevention of rheumatic fever are not available at present.) For information on use in pediatric patients, see PRECAUTIONS, Pediatric Use. Skin and Skin Structure: Uncomplicated Skin and Skin Structure Infections caused by S. aureus (including penicillinase-producing strains) or S. pyogenes. Abscesses should be surgically drained as clinically indicated. Urinary Tract: Uncomplicated Urinary Tract Infections (cystitis) caused by E. coli or S. saprophyticus*. NOTE: In considering the use of loracarbef in the treatment of cystitis, loracarbef's lower bacterial eradication rates and lower potential for toxicity should be weighed against the increased eradication rates and increased potential for toxicity demonstrated by some other classes of approved agents (see CLINICAL STUDIES.) Uncomplicated Pyelonephritis: caused by E. coli. *Although treatment of infections due to this organism in this organ system demonstrated a clinically acceptable overall outcome, efficacy was studied in fewer than 10 infections. Culture and susceptibility testing should be performed when appropriate to determine the causative organism and its susceptibility to loracarbef. Therapy may be started while awaiting the results of these studies. Once these results become available, antimicrobial therapy should be adjusted accordingly.

Launch Date

6.9413759E11
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
19.21 mg/L
400 mg single, oral
dose: 400 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
LORACARBEF serum
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
13.64 mg/L
400 mg single, oral
dose: 400 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
LORACARBEF serum
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FED
14 μg/mL
400 mg single, oral
dose: 400 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
LORACARBEF plasma
Homo sapiens
population: UNHEALTHY
age: CHILD
sex: UNKNOWN
food status: UNKNOWN
8 μg/mL
200 mg single, oral
dose: 200 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
LORACARBEF plasma
Homo sapiens
population: UNHEALTHY
age: CHILD
sex: UNKNOWN
food status: UNKNOWN
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
33.04 mg × h/L
400 mg single, oral
dose: 400 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
LORACARBEF serum
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
35.38 mg × h/L
400 mg single, oral
dose: 400 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
LORACARBEF serum
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FED
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
70.31 min
400 mg single, oral
dose: 400 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
LORACARBEF serum
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FASTED
102.33 min
400 mg single, oral
dose: 400 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
LORACARBEF serum
Homo sapiens
population: HEALTHY
age: ADULT
sex: MALE
food status: FED
Doses

Doses

DosePopulationAdverse events​
400 mg 2 times / day steady, oral
Recommended
Dose: 400 mg, 2 times / day
Route: oral
Route: steady
Dose: 400 mg, 2 times / day
Sources:
unhealthy, adult
n = 235
Health Status: unhealthy
Condition: bacterial infections
Age Group: adult
Sex: unknown
Population Size: 235
Sources:
Disc. AE: Diarrhea, Allergic exanthema...
AEs leading to
discontinuation/dose reduction:
Diarrhea (1 patient)
Allergic exanthema (1 patient)
Abdominal pain (1 patient)
Sources:
30 mg/kg 1 times / day steady, oral (max)
Highest studied dose
Dose: 30 mg/kg, 1 times / day
Route: oral
Route: steady
Dose: 30 mg/kg, 1 times / day
Sources:
unhealthy, children and adults
n = 4506
Health Status: unhealthy
Condition: bacterial infections
Age Group: children and adults
Sex: M+F
Population Size: 4506
Sources:
Disc. AE: Hypersensitivity, Diarrhea...
AEs leading to
discontinuation/dose reduction:
Hypersensitivity (16 patients)
Diarrhea (12 patients)
Nausea and vomiting (16 patients)
Abdominal pain (9 patients)
Headache (5 patients)
Neurologic disorder NOS (2 patients)
Sources:
AEs

AEs

AESignificanceDosePopulation
Abdominal pain 1 patient
Disc. AE
400 mg 2 times / day steady, oral
Recommended
Dose: 400 mg, 2 times / day
Route: oral
Route: steady
Dose: 400 mg, 2 times / day
Sources:
unhealthy, adult
n = 235
Health Status: unhealthy
Condition: bacterial infections
Age Group: adult
Sex: unknown
Population Size: 235
Sources:
Allergic exanthema 1 patient
Disc. AE
400 mg 2 times / day steady, oral
Recommended
Dose: 400 mg, 2 times / day
Route: oral
Route: steady
Dose: 400 mg, 2 times / day
Sources:
unhealthy, adult
n = 235
Health Status: unhealthy
Condition: bacterial infections
Age Group: adult
Sex: unknown
Population Size: 235
Sources:
Diarrhea 1 patient
Disc. AE
400 mg 2 times / day steady, oral
Recommended
Dose: 400 mg, 2 times / day
Route: oral
Route: steady
Dose: 400 mg, 2 times / day
Sources:
unhealthy, adult
n = 235
Health Status: unhealthy
Condition: bacterial infections
Age Group: adult
Sex: unknown
Population Size: 235
Sources:
Diarrhea 12 patients
Disc. AE
30 mg/kg 1 times / day steady, oral (max)
Highest studied dose
Dose: 30 mg/kg, 1 times / day
Route: oral
Route: steady
Dose: 30 mg/kg, 1 times / day
Sources:
unhealthy, children and adults
n = 4506
Health Status: unhealthy
Condition: bacterial infections
Age Group: children and adults
Sex: M+F
Population Size: 4506
Sources:
Hypersensitivity 16 patients
Disc. AE
30 mg/kg 1 times / day steady, oral (max)
Highest studied dose
Dose: 30 mg/kg, 1 times / day
Route: oral
Route: steady
Dose: 30 mg/kg, 1 times / day
Sources:
unhealthy, children and adults
n = 4506
Health Status: unhealthy
Condition: bacterial infections
Age Group: children and adults
Sex: M+F
Population Size: 4506
Sources:
Nausea and vomiting 16 patients
Disc. AE
30 mg/kg 1 times / day steady, oral (max)
Highest studied dose
Dose: 30 mg/kg, 1 times / day
Route: oral
Route: steady
Dose: 30 mg/kg, 1 times / day
Sources:
unhealthy, children and adults
n = 4506
Health Status: unhealthy
Condition: bacterial infections
Age Group: children and adults
Sex: M+F
Population Size: 4506
Sources:
Neurologic disorder NOS 2 patients
Disc. AE
30 mg/kg 1 times / day steady, oral (max)
Highest studied dose
Dose: 30 mg/kg, 1 times / day
Route: oral
Route: steady
Dose: 30 mg/kg, 1 times / day
Sources:
unhealthy, children and adults
n = 4506
Health Status: unhealthy
Condition: bacterial infections
Age Group: children and adults
Sex: M+F
Population Size: 4506
Sources:
Headache 5 patients
Disc. AE
30 mg/kg 1 times / day steady, oral (max)
Highest studied dose
Dose: 30 mg/kg, 1 times / day
Route: oral
Route: steady
Dose: 30 mg/kg, 1 times / day
Sources:
unhealthy, children and adults
n = 4506
Health Status: unhealthy
Condition: bacterial infections
Age Group: children and adults
Sex: M+F
Population Size: 4506
Sources:
Abdominal pain 9 patients
Disc. AE
30 mg/kg 1 times / day steady, oral (max)
Highest studied dose
Dose: 30 mg/kg, 1 times / day
Route: oral
Route: steady
Dose: 30 mg/kg, 1 times / day
Sources:
unhealthy, children and adults
n = 4506
Health Status: unhealthy
Condition: bacterial infections
Age Group: children and adults
Sex: M+F
Population Size: 4506
Sources:
PubMed

PubMed

TitleDatePubMed
Loracarbef (LY163892) versus cefaclor and norfloxacin in the treatment of uncomplicated pyelonephritis.
1992 Jun 22
Loracarbef (LY163892) versus cefaclor in the treatment of bacterial skin and skin-structure infections in an adult population.
1992 Jun 22
Loracarbef versus penicillin VK in the treatment of streptococcal pharyngitis and tonsillitis in an adult population.
1992 Jun 22
The carbacephems: a new beta-lactam antibiotic class.
1992 Jun 22
Loracarbef: a new orally administered carbacephem antibiotic.
1993 Mar
Loracarbef. A review of its antimicrobial activity, pharmacokinetic properties and therapeutic efficacy.
1993 May
Transport mechanisms responsible for the absorption of loracarbef, cefixime, and cefuroxime axetil into human intestinal Caco-2 cells.
1994 Apr 20
Structures of ceftazidime and its transition-state analogue in complex with AmpC beta-lactamase: implications for resistance mutations and inhibitor design.
2001 Aug 7
Antimicrobial susceptibilities of clinical isolates of Haemophilus influenzae and Moraxella catarrhalis collected during 1999-2000 from 13 countries.
2001 Dec
Antibiotic susceptibilities among recent clinical isolates of Haemophilus influenzae and Moraxella catarrhalis from fifteen countries.
2001 Jan
Compliance issues related to the selection of antibiotic suspensions for children.
2001 Jan
Effect of step-down therapy of ceftriaxone plus loracarbef versus parenteral therapy of ceftriaxone on the intestinal microflora in patients with community-acquired pneumonia.
2001 Jul
The fecal microflora of 1-3-month-old infants during treatment with eight oral antibiotics.
2002 Jun
Patient, physician, and nurse satisfaction with antibiotics.
2002 Jun
Natural antibiotic susceptibility of Enterobacter amnigenus, Enterobacter cancerogenus, Enterobacter gergoviae and Enterobacter sakazakii strains.
2002 Sep
Natural antibiotic susceptibility of Proteus spp., with special reference to P. mirabilis and P. penneri strains.
2003 Feb
Natural antibiotic susceptibility of strains of Serratia marcescens and the S. liquefaciens complex: S. liquefaciens sensu stricto, S. proteamaculans and S. grimesii.
2003 Jul
[Haemophilus influenzae and betalactam resistance: description of bla TEM gene deletion].
2003 Jun
Serologically documented loracarbef (Lorabid)-induced immune thrombocytopenia.
2003 May
Natural antibiotic susceptibility of Ewingella americana strains.
2003 Oct
Cefdinir: a review of its use in the management of mild-to-moderate bacterial infections.
2004
Twice-daily dosing of loracarbef 15 mg/kg versus 30 mg/kg in the treatment of children with acute sinusitis.
2005
[Evaluation of predisposing factors and bacteriologic agents in pediatric rhinosinusitis].
2005
Penicillin V, loracarbef and clindamycin in tonsillar surface fluid during acute group A streptococcal pharyngotonsillitis.
2005
Staphylococcal skin infections in children: rational drug therapy recommendations.
2005
Prediction of genotoxicity of chemical compounds by statistical learning methods.
2005 Jun
Antimicrobial susceptibility of Staphylococcus aureus isolated from colonized hospital personnel.
2006 Jul-Sep
The effect of four different types of diet on the bioavailability of loracarbef.
2007 Oct-Dec
Progress in the development of early diagnosis and a drug with unique pharmacology to improve cancer therapy.
2008 Oct 13
Patents

Sample Use Guides

In the treatment of adults with pharyngitis, acute bronchitis, tonsillitis and uncomplicated infections of skin and skin structures, loracarbef was studied at a dosage of 200mg twice daily. Patients with acute pneumonia, sinusitis and uncomplicated pyelonephritis were treated with 400mg twice daily in clinical studies. Seven-day courses of 200 or 400mg twice daily were used to treat acute exacerbations of chronic bronchitis (acute superimposed on chronic). A once-daily dose of 200mg is used to treat acute cystitis. In infants and children, 30 mg/kg in divided doses 12-hourly is used to treat acute otitis media, while 15 mg/kg is recommended for the treatment of pharyngitis, tonsillitis and impetigo. Dosage should be adjusted in patients with renal impairment whose creatine clearance is below 2.9 L/h (49 ml/min).
Route of Administration: Oral
In Vitro Use Guide
The MIC50 of loracarbef (KT3777) ranged from 0.2 to 3.13 micrograms/ml for clinical isolates of Staphylococcus aureus, Streptococci, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Haemophilus influenzae, and Neisseria gonorrhoeae.
Name Type Language
LORACARBEF ANHYDROUS
Common Name English
loracarbef [INN]
Common Name English
Loracarbef [WHO-DD]
Common Name English
ANHYDROUS LORACARBEF
Common Name English
LORACARBEF [MI]
Common Name English
LORBEF
Brand Name English
LORACARBEF, ANHYDROUS
Common Name English
Classification Tree Code System Code
LIVERTOX 569
Created by admin on Fri Dec 15 15:32:53 UTC 2023 , Edited by admin on Fri Dec 15 15:32:53 UTC 2023
NDF-RT N0000011161
Created by admin on Fri Dec 15 15:32:53 UTC 2023 , Edited by admin on Fri Dec 15 15:32:53 UTC 2023
WHO-ATC J01DC08
Created by admin on Fri Dec 15 15:32:53 UTC 2023 , Edited by admin on Fri Dec 15 15:32:53 UTC 2023
NDF-RT N0000011161
Created by admin on Fri Dec 15 15:32:53 UTC 2023 , Edited by admin on Fri Dec 15 15:32:53 UTC 2023
NDF-RT N0000011161
Created by admin on Fri Dec 15 15:32:53 UTC 2023 , Edited by admin on Fri Dec 15 15:32:53 UTC 2023
NDF-RT N0000011161
Created by admin on Fri Dec 15 15:32:53 UTC 2023 , Edited by admin on Fri Dec 15 15:32:53 UTC 2023
NDF-RT N0000175488
Created by admin on Fri Dec 15 15:32:53 UTC 2023 , Edited by admin on Fri Dec 15 15:32:53 UTC 2023
NDF-RT N0000011161
Created by admin on Fri Dec 15 15:32:53 UTC 2023 , Edited by admin on Fri Dec 15 15:32:53 UTC 2023
NDF-RT N0000011161
Created by admin on Fri Dec 15 15:32:53 UTC 2023 , Edited by admin on Fri Dec 15 15:32:53 UTC 2023
NDF-RT N0000011161
Created by admin on Fri Dec 15 15:32:53 UTC 2023 , Edited by admin on Fri Dec 15 15:32:53 UTC 2023
NDF-RT N0000011161
Created by admin on Fri Dec 15 15:32:53 UTC 2023 , Edited by admin on Fri Dec 15 15:32:53 UTC 2023
NDF-RT N0000011161
Created by admin on Fri Dec 15 15:32:53 UTC 2023 , Edited by admin on Fri Dec 15 15:32:53 UTC 2023
NDF-RT N0000011161
Created by admin on Fri Dec 15 15:32:53 UTC 2023 , Edited by admin on Fri Dec 15 15:32:53 UTC 2023
NDF-RT N0000011161
Created by admin on Fri Dec 15 15:32:53 UTC 2023 , Edited by admin on Fri Dec 15 15:32:53 UTC 2023
NDF-RT N0000011161
Created by admin on Fri Dec 15 15:32:53 UTC 2023 , Edited by admin on Fri Dec 15 15:32:53 UTC 2023
NCI_THESAURUS C357
Created by admin on Fri Dec 15 15:32:53 UTC 2023 , Edited by admin on Fri Dec 15 15:32:53 UTC 2023
Code System Code Type Description
CAS
76470-66-1
Created by admin on Fri Dec 15 15:32:53 UTC 2023 , Edited by admin on Fri Dec 15 15:32:53 UTC 2023
PRIMARY
FDA UNII
W72I5ZT78Z
Created by admin on Fri Dec 15 15:32:53 UTC 2023 , Edited by admin on Fri Dec 15 15:32:53 UTC 2023
PRIMARY
EPA CompTox
DTXSID7023223
Created by admin on Fri Dec 15 15:32:53 UTC 2023 , Edited by admin on Fri Dec 15 15:32:53 UTC 2023
PRIMARY
SMS_ID
100000082010
Created by admin on Fri Dec 15 15:32:53 UTC 2023 , Edited by admin on Fri Dec 15 15:32:53 UTC 2023
PRIMARY
INN
6360
Created by admin on Fri Dec 15 15:32:53 UTC 2023 , Edited by admin on Fri Dec 15 15:32:53 UTC 2023
PRIMARY
EVMPD
SUB08578MIG
Created by admin on Fri Dec 15 15:32:53 UTC 2023 , Edited by admin on Fri Dec 15 15:32:53 UTC 2023
PRIMARY
MERCK INDEX
m6903
Created by admin on Fri Dec 15 15:32:53 UTC 2023 , Edited by admin on Fri Dec 15 15:32:53 UTC 2023
PRIMARY Merck Index
PUBCHEM
5284585
Created by admin on Fri Dec 15 15:32:53 UTC 2023 , Edited by admin on Fri Dec 15 15:32:53 UTC 2023
PRIMARY
NCI_THESAURUS
C61815
Created by admin on Fri Dec 15 15:32:53 UTC 2023 , Edited by admin on Fri Dec 15 15:32:53 UTC 2023
PRIMARY